Form Dr 1369 - Colorado State Sales And Use Tax Exemption For Low-Emitting Heavy Vehicles Affidavit (Submit One Form For Each Vehicle)
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1DR 1369 (08/05/14)
*141369==19999*
COLORADO DEPARTMENT OF REVENUE
Denver, CO 80261-0009
(303) 238-SERV (7378)
Colorado State Sales and Use Tax Exemption For
Low-Emitting Heavy Vehicles Affidavit
(Submit one form for each vehicle)
Purchaser’s Information
Purchaser’s Name
Purchaser’s Telephone Number
(
)
Purchaser’s Address
City
State
ZIP
Vehicle Information
Sales on or before June 30, 2014
Motor vehicles greater than 10,000 pounds gross motor vehicle
the Federal Clean Air Act as meeting an emission standard equal
weight rating (GVWR) that are certified by the United States
to or more stringent than the low-emitting vehicle (LEV) standard
Environmental Protection Agency (EPA) or any state provided in
are exempt from state sales and use tax. [§39-26-719, C.R.S.]
Sales on or after July 1, 2014
Please check the appropriate box below
Please check appropriate box for the vehicle weight
The vehicle is equipped by the manufacturer to operate on
compressed natural gas (CNG) or liquefied petroleum gas
Motor vehicles greater than 26,000 pounds gross motor
(LPG). The vehicle can run exclusively CNG or LPG or as a bi-
vehicle weight rating (GVWR) that are certified by the United
fuel or duel fuel that can operate on traditional fuel and CNG or
States Environmental Protection Agency (EPA) as provided
LNG. The vehicle is equipped with a CNG or LPG conversion
in the federal heavy-duty national program that includes new
certified by the EPA.
greenhouse gas emissions standards are exempt from state
sales and use tax. Parts that are certified by the EPA are also
The vehicle is equipped by the manufacturer to operate on
exempt from state sales and use tax when converting motor
liquefied natural gas (LNG) or hydrogen. The vehicle can run
vehicles greater than 26,000 pounds GVWR.
exclusively LNG or hydrogen, or as a bi-fuel or duel fuel that
can be operated on traditional fuel and LNG or hydrogen.
Motor vehicles greater than 10,000 pounds gross vehicle
The vehicle is equipped with a LNG or hydrogen conversion
weight rating (GVWR) are exempt from state sales and use
certified by the EPA.
tax when one of the following criteria are met:
The vehicle is equipped by the manufacturer as an electricity
truck or plug-in hybrid electric truck. The vehicle is converted
to an electric truck or plug-in hybrid electric truck.
Year
Model
Make
Body Type
Vehicle Identification Number (VIN)
Date of Sale
Qualification Documents
The following documents MUST be provided to the county clerk when the vehicle is registered in Colorado.
A copy of this form, DR 1369 Colorado State Sales and Use
Evidence of the gross motor vehicle weight rating (GVWR)
Tax Exemption For Low-Emitting Heavy Vehicles Affidavit
EPA certification
Dealer Information
The undersigned certifies that the referenced vehicle meets the requirements of §39-26-719, C.R.S.
Dealer’s Name
Dealer’s Telephone Number
(
)
Dealer’s Address
City
State
ZIP
Dealer #
Dealer’s Sales Tax Account Number
Printed Name of Dealer Representative
Signature of Dealer Representative
Date
Local Taxes: Unless cities, counties or special districts have
Claiming the Tax Exemption: The dealer should not collect the
adopted an ordinance or resolution to exempt LEV heavy vehicles,
state sales tax on vehicles that qualify for this exemption, although
local taxes are due on the purchase or sale of LEV heavy vehicles.
local taxes may still be due. Likewise, the state tax should not be
Refer to Colorado Sales/Use Tax Rates (DR 1002) to determine if a
collected at the time the vehicle is registered at the county office.
city or county has allowed this exemption. Home-rule cities are also
If any sales tax is paid in error, a Claim for Refund (DR 0137) may
listed in the DR 1002. Most home-rule cities enact their own sales
be submitted to the state within three years from the purchase
date to receive a refund of taxes paid in error. Evidence of gross
tax ordinances and collect their own taxes. Contact home-rule cities
directly for their rules regarding sales taxes on heavy vehicles.
vehicle weight rating and EPA certification must be submitted
with the claim to qualify for a refund.
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